Serum Total Antioxidant Capacity of Epileptic Children before and after Monotherapy with Sodium Valproate, Carbamazepine,

Background: Brain is highly vulnerable to free radical damage due to a large quantity of mitochondria, a considerable amount of oxidizable polyunsaturated fatty acids, a ratio of high oxygen consumption, and less antioxidant capacity. The experimental and clinical data suggest a putative role of oxidative stress in the pathophysiology of seizures and epileptic syndromes.Objectives: A case-control study was carried out to compare serum total antioxidant capacity in the newly diagnosed children with epilepsy and that of a control group of healthy children at the same age.Patients and Methods: A total of 130 participants (65 in each group) aged between 1 and 17 years participated in this study. Serum total antioxidant capacity was compared between two groups before drug administration. The effect of antiepileptic therapy on the serum total antioxidant capacity also was studied in children with epilepsy before and 3 months after antiepileptic drug administration. Serum total antioxidant capacity values were measured based on Erel's method using an automated commercial kit. This method is based on the bleaching of the characteristic color of a more stable 2,2’‑azinobis‑(3‑ethylbenzothiazoline‑6‑sulfonic acid) radical cation by antioxidants. The results were expressed in mmol Trolox equivalent/lResults: Serum total antioxidant capacity values was significantly lower in the patients group before drug administration [mean (SD): 1.31 (0.19) mmol/L] than that of the control group [mean (SD): 1.46 (0.21) mmol/L] (P < 0.001). In the patients group, no differences were found in the serum total antioxidant capacity before and 3 months after anticonvulsant monotherapy.Conclusion: Reduced serum total antioxidant capacity, and an increased vulnerability to oxidative stress should be considered in the children with epilepsy

Seismotectonics, Geomorphology and Paleoseismology of the Doroud Fault, a Source of Seismic Hazard in Zagros

In this study, the active tectonics, paleoseismicity, and seismic hazards of the Doroud Fault are examined through high-resolution satellite image interpretations, field investigations, outcrop and trench excavations, and the dating of geochronology samples. The Doroud Fault (DF), one of the essential segments of the Main Recent Fault in the northern margin of the Zagros mountain range, has a historical and instrumental background of high seismicity. We present the first constraints from tectonic geomorphology and paleoseismology along the Doroud Fault near the capital city of Dorud. Detailed observations from satellite imagery, field investigations, real-time kinematic (RTK) measurements, paleoseismological trenching, the radiocarbon (C14), and optically stimulated luminescence (OSL) as ages allowed us to map the fault in detail, describe and characterize its kinematics, and document its recent activity and seismic behavior (cumulative displacements, paleoseismicity, and magnitude, as well as recurrence interval) relevant to the recent seismic activity of the Doroud Fault during the late Holocene as one of the most important seismogenic faults in Zagros. Modern alluvial terraces of gullies and loess accumulations are systematically deflected and/or offset with co-seismic rupture, landslides, and scarps, indicating that the Doroud Fault has been active in the late Quaternary and is characterized by dextral strike–slip movements with a normal component. In addition, our findings provide a comprehensive analysis of the fault displacement, the timing of paleoearthquakes, and the right-lateral slip rate of the Doroud Fault. The late Holocene slip rate of the Doroud Fault using the OSL dating the gully is as follows: the minimum and maximum horizontal slip rates are estimated to be 1.82 and 2.71 mm/yr, and vertical slip rates of 1.03 and 1.53 mm/yr are calculated for the past 4600 ± 900 years in the middle segment of the fault. This study focused on a paleoseismological trench within the archeological sites of Darbe-Astaneh. The central portion of the fault has historically hosted more than nine earthquakes in the last 66 ka years, according to the study’s findings. According to paleoseismology studies, the Doroud Fault has the seismic capability to cause earthquakes with a magnitude of more than 7.4 and a total slip rate of about 3.83 ± 0.1 m. The average recurrence interval for the identified paleoearthquakes is approximately 104 ± 7 years

The Effect of Herbal Medicines on Postpartum Depression, and Maternal-Infant Attachment in Postpartum Mother: A Systematic Review and Meta-Analysis

Background: Postpartum depression has negative effects on mother, child and family. Regarding the side effects of antidepressants and because of contradictory results on the effects of herbal medicines, the present meta-analysis was conducted to evaluate the efficacy of herbal medicines in treatment of postpartum depression and maternal-infant attachment. Materials and Methods: An extensive search was done in databases of Medline, EMBASE, Scopus, Cochrane, and Web of Science in English databases as well as IranDoc, Magiran, Medlib and SID, in Persian databases with no time limitations until November 2018. Two independent researchers screened articles, in the next step, full texts of probably relevant articles were summarized and categorized based on the evaluated outcomes and overall effect size was presented. Results: The meta-analysis of five trials showed score of depression was lower in herbal medicines group compared to placebo (Standardized Mean Difference [SMD= -0.648], 95% confidence interval [CI]: -0.849 to -0.446). Heterogeneity was non-significant (I-2=0%, p=.476). Meta-analysis of compounds containing lavender decreased score of depression significantly compared to control group. Heterogeneity was non-significant (SMD=-0.629, 95%CI: -0.847 to -0.411, I-2=9.8%, p=.34). The lavender meta-analysis of three studies showed a significant effect in comparison to control group (SVM=-0.570, 95%CI: -0.799 to -0.341; I-2=9.8%, p=.34). The aromatherapy meta-analysis showed that aromatherapy with or without massage could lead to a significant decrease in score of depression compared to control group (SMD= -0.637, 95%CI: -0.924 to -0.333; I-2=66%, p=0.084). Some herbal medicines showed a significant effect on maternal-infant attachment and feelings toward baby scale. Conclusion: Herbal medicines can be considered as an alternative option in treatment of postpartum depression. Also, maternal-infant attachment and feelings toward baby scale were affected by herbal medicines

Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Background Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Methods Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. Findings In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world’s highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%.Peer ReviewedPostprint (published version

Integration of discriminative and generative models for activity recognition in smart homes

Activity recognition in smart homes enables the remote monitoring of elderly and patients. In healthcare systems, reliability of a recognition model is of high importance. Limited amount of training data and imbalanced number of activity instances result in over-fitting thus making recognition models inconsistent. In this paper, we propose an activity recognition approach that integrates the distance minimization (DM) and probability estimation (PE) approaches to improve the reliability of recognitions. DM uses distances of instances from the mean representation of each activity class for label assignment. DM is useful in avoiding decision biasing towards the activity class with majority instances; however, DM can result in over-fitting. PE on the other hand has good generalization abilities. PE measures the probability of correct assignments from the obtained distances, while it requires a large amount of data for training. We apply data oversampling to improve the representation of classes with less number of instances. Support vector machine (SVM) is applied to combine the outputs of both DM and PE, since SVM performs better with imbalanced data and further improves the generalization ability of the approach. The proposed approach is evaluated using five publicly available smart home datasets. The results demonstrate better performance of the proposed approach compared to the state-of-the-art activity recognition approaches

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe